The box below will take you to the Client Agreement and Optional Questionnaire. Please read through the Client Agreement. If you agree, you can send it to me by clicking on the "Submit" button at the bottom of the form.

At the end of the Client Agreement, there is an optional questionnaire, which allows me to gain some initial information about you, allows me to better judge your situation, and offer you the best possible advice. Please respond to as many questions as you're comfortable answering. The questionnaire can typically be completed in 5 to 10 minutes. To start the counseling process, please click on the Agreement/Questionnaire box below.

*NOTE* If you're using a pop-up stopper, you may need to depress (and hold) the Ctrl key and then click on the Agreement/Questionnaire box below in order for the Agreement & Questionnaire to be displayed.